Abandoning informed consent?

Editor’s Note: Kirsten Bell was invited to contribute this post based on her recent American Anthropologist article, “Resisting Commensurability: Against Informed Consent as an Anthropological Virtue.”

Kirsten Bell

Department of Anthropology

University of British Columbia


There’s a courtroom scene in Rob Reiner’s film A Few Good Men (no, not “you can’t handle the truth”) where a physician has just provided damning testimony against the clients of Lieutenant Daniel Kaffee (Tom Cruise), Lieutenant Commander JoAnne Galloway (Demi Moore) and Lieutenant Sam Weinberg (Kevin Pollack).  Kaffee lodges his objection to the physician’s testimony and the judge overrules it.  Galloway then “strenuously objects”, which merely causes the judge to dig in his heels.  Afterwards, an annoyed Weinberg says to Galloway: “I strenuously object?  Is that how it works?  Hmm?  ‘Objection’.  ‘Overruled’.  ‘Oh no, no, no.  I strenuously object’.  ‘Oh, well, if you strenuously object then I should take some time to reconsider’”.  His point is that the formulation is both redundant and absurd.

In this post I want to consider another absurd redundancy, namely “fully informed consent”.  However, while “strenuously objecting” has never caught on as a legal strategy, “fully informed consent” makes an appearance in everything from the Stanford Encyclopedia of Philosophy to the AAA Code of Ethics (see “be open and honest regarding your work”).  Surely, consent is either informed or it isn’t, so why the qualifier?  In my view, its addition reveals the central problem with the concept itself, namely, that while it seems self-evident and straightforward, the more deeply you look, the murkier it becomes.  That vapid adverbs have been piled on in the hopes of clarifying its meaning (what’s next? “Really, truly informed consent”?) suggests that we are dealing with the fallacy of misplaced concreteness.

It’s worth bearing in mind that “informed consent” is a hypothetical construct.  Even the Belmont Report, the document responsible for enshrining the doctrine as part of a Holy Trinity of universal ethical principles, was hedging its bets on whether it was, in fact, possible.  As others before me have noted, it becomes especially meaningless when applied to anthropological research.  What on earth does it mean to state that, “Anthropologists have an obligation to ensure that research participants have freely granted consent”?  Freely granted consent to what?  To be studied?  To be written about?  (These are not the same thing.)  And how can one share “the expected outcomes [and] anticipated impacts of the research” when these are unknown at the outset?  Again, statements like these might seem self-evident, but upon closer inspection appear to be rather empty.

These are not new concerns.  What is relatively new is the AAA’s embrace of the informed consent doctrine 16 years ago and the lack of debate the concept engendered in the recent online discussions about the proposed revisions to the Code of Ethics.  All this would suggest that despite its problems, it has reached the status of an unassailable value.  After all, how can one be against informed consent?  That this has become our default response to critics of the doctrine suggests that it has become a totalizing frame, one that crowds out more a complex reading of the distinct issues it currently collapses, from community permissions to conduct fieldwork, to communication about one’s research on the ground, to the politics of writing and representation.  My suspicion is that untethering discussions about anthropological research ethics from the stranglehold of “informed consent” will allow us to talk in a more meaningful way about the complexities of communication about our research, which are far from the self-evident, straightforward, primarily technical transaction the doctrine implies.

In sum, despite its apparent unassailability, there are good reasons to take stock of our ethical equipment to ensure it does what think it does and what we want it to, otherwise we are in danger of ending up like misguided Vizzini (Wallace Shawn) in The Princess Bride, another Rob Reiner film.  After he misuses the term “inconceivable” for the dozenth time, Inigo Montoya (Mandy Patinkin), his hired swordsman, remarks: “You keep using that word.  I do not think it means what you think it means”.

“Do Some Good” and Other Lessons from Practice for a New AAA Code of Ethics

Elizabeth K. Briody and Tracy Meerwarth Pester

What do you do if you don’t see yourself or your work represented in the AAA ethics code?

Maybe you do what we did. First, we asked ourselves, how strongly connected were we to the discipline of anthropology? We took stock of our ties and here is what we found. Both of us

  • Hold advanced anthropology degrees
  • Became AAA members well over a decade ago
  • Have served in AAA leadership positions
  • Have received AAA awards
  • Have produced a AAA video and/or published in AAA journals.

Our AAA experiences indicated we were engaged in the discipline’s mission, services, and products.

Second, we thought, why don’t we examine the degree of fit between our anthropological work and the current ethics code? That way we could see the extent to which our impressions of the code were valid. Since we both spent much of our professional careers as researchers at General Motors R&D, we decided to compare our actions on four GM R&D projects to the AAA’s 2012 Principles of Professional Responsibility. Our analysis became a friendly test of the AAA ethics code (see Journal of Business Anthropology, 2014, Special Issue 1, http://ej.lib.cbs.dk/index.php/jba/article/view/4260).

We learned that the current code does not “reflect core principles shared across subfields and contexts of practice” as the preamble reads. Instead, the code has a far narrower focus. It is written for those who conduct research – with the word “research” or its cognates appearing 65 times – and not for other types of anthropological work. Moreover, even though we were researchers at a premier industrial lab, terms that we used to describe our anthropological activities and impact did not appear in the code: “problem solving,” “change,” “intervention,” “management,” “recommendations,” “tools,” “applications,” and “training.” Anthropological practice includes a significant implementation component. In our case, implementation was an extension of our research. For other professional anthropologists, implementation, management, or administration may be their primary job element.

The AAA ethics code also ignored our dual identities: anthropologists – yes, but employed by GM. The AAA code and GM’s corporate code of conduct were complementary because they emphasized different domains. We believe guidance from both codes contributed to our mindful practice.

But, what really surprised us about the code was the preoccupation with the concept of “harm” with no corresponding emphasis on the concept of “help.” Professional anthropologists work inside some cultural system – whether as employees, consultants, contractors, or volunteers – and typically work toward a more effective system. Their focus incorporates the “Do No Harm” principle, but accentuates the “Do Some Good” principle. The ethics code left us wondering:

  • Why doesn’t the code value the use of anthropological theories and methods to help improve the human condition?
  • How can anthropologists adhere to an ethical code if it ignores the prospects of change as well as the role of professional anthropologists in that process?

Third, we asked ourselves, were we outliers? Could it be that our type of anthropological work was an exception to the rule? No, we concluded. We knew that we were not alone in the arena of practice and that the discipline had been evolving into a mixed model of academic and professional anthropologists. One indicator of this shift was the rise in the number of applied programs (see http://www.copaa.info/programs_in_aa/list.htm). A second and related indicator was the increasing number of graduating MA and PhD anthropologists moving into professional careers.

We understand that the AAA ethics code is expected to be a living document, revamped as conditions internal and external to the discipline change. We believe that the time for creating an inclusive anthropological code of ethics is now. So, where do we go from here?

We recommend that the AAA Committee on Ethics convene two working groups – one of professional anthropologists and the other of academically-based anthropologists. The two groups should work together to create a common framework pertaining to the relationship between anthropological work and ethics; the framework might include such elements as motivation, tasks, relationships, work environments, learning, and impact. Then separately, the two groups identify core features of the framework using their own work-related experiences and the literature to guide them. Finally, the two groups reassemble to integrate the ethical dimensions of professional and academic work into a cohesive whole.

We anticipate the creation of a new code, rather than a revision of the existing one – a code that represents the evolving discipline of anthropology holistically, accurately, and effectively. This process would be an important and relevant way to “Do Some Good!”

Elizabeth K. Briody currently serves on the AAA Executive Board in the Practicing/Professional Seat. Tracy Meerwarth Pester currently serves on the NAPA Ethics Committee.